Pericardial adhesion and performance of hemodynamically significant constrictive pericarditis using cine magnetic resonance feature tracking.

To investigate the diagnostic performance of cine magnetic resonance feature tracking (FT) for pericardial adhesions and hemodynamically significant constrictive pericarditis (CP). This retrospective study included patients who underwent cardiac magnetic resonance (CMR) imaging between 2011 and 2021. Twenty-four patients (median age, 73 years; seven females) suspected of having CP and undergoing CMR were selected (CP group). Age-matched 24 participants with heart failure (HF) and 24 healthy volunteers were also analyzed. The FT method assessed septal bounce, the presence of a dip or plateau pattern, and pericardial adhesions. The diagnostic performance, including the area under the receiver operating characteristic curve (AUC) for hemodynamically significant CP, was evaluated against catheterization results, and the adhesion detection in the combined CP and HF control was based on cine tagging or surgical records. Septal bounce was detected in 54% (13/24) of the patients by FT and 38% (9/24) of the patients by visual evaluation in the CP group but not in the HF or normal group (p < 0.001). To detect hemodynamically significant CP, the sensitivity and specificity of each finding were as follows: septal bounce, 85% (11/13) and 82% (9/11); adhesion, 100% (13/13) and 9% (1/11); dip, 77% (10/13) and 36% (4/11); and plateau, 69% (9/13) and 46% (5/11), respectively. The sensitivity and specificity of pericardial adhesion detection using FT and visual evaluation were 96% (23/24) and 100% (24/24), respectively, and the AUCs were 0.998 and 0.999, respectively. CMR-FT demonstrates high sensitivity and specificity for diagnosing hemodynamically significant CP and pericardial adhesions.